Provider Demographics
NPI:1154883577
Name:ALSHARKAWY, YUSUF A
Entity type:Individual
Prefix:MR
First Name:YUSUF
Middle Name:A
Last Name:ALSHARKAWY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-1218
Mailing Address - Country:US
Mailing Address - Phone:270-244-7250
Mailing Address - Fax:
Practice Address - Street 1:2308 HIGHWAY 144
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-0175
Practice Address - Country:US
Practice Address - Phone:270-926-7751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYI14149390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYI14149OtherPHARMACY INTERN LICENSE